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Insulin Resistance: The Metabolic Syndrome X
Gerald Reaven, the discoverer of Syndrome X, and a panel of world-class investigators thoughtfully summarize our current understanding of how insulin resistance and its compensating hyperinsulinemia play a major role in the pathogenesis and clinical course of high blood pressure and cardiovascular disease-the so-called diseases of Western civilization. These distinguished authorities detail, for the first time, the pathophysiological consequences and the clinical syndromes, excluding Type 2 diabetes, related to insulin resistance. They also examine the genetic and lifestyle factors that contribute to the wide differences in insulin action that exist in the population at large. Timely and authoritative, Insulin Resistance: The Metabolic Syndrome X illuminates the full importance of insulin resistance as a major cause of hypertension, heart disease, and polycystic ovary syndrome.
Hormone Replacement Therapy
A. Wayne Meikle and a distinguished panel of expert clinicians bring to bear their extensive knowledge and experience in managing adults and children undergoing hormone replacement therapy for the pituitary, parathyroid, thyroid, pancreas, adrenal glands, and gonads. Emphasizing proper patient management, the book provides to specialists and general practitioners alike time-tested, cutting-edge guidelines on the use, monitoring, and dosage of hormone therapeutics in the treatment of disorders of endocrine function, while giving an exhaustive analysis of each therapy. Comprehensive and eminently practical, Hormone Replacement Therapy captures the most recent advances in hormone replacement therapeutics and is certain to serve endocrinologists, gynecologists, pediatricians, urologists, internists, and family practitioners as today's standard reference for managing and monitoring their patients.
Hormone Resistance Syndromes
Leading clinicians review in depth the clinical and molecular aspects of the hormone resistance syndromes caused by receptor mutations. These mutations are involved in a large number of disorders, including dwarfism, Laron syndrome, pseudohypoparathyroidism, insulin resistance, resistance to thyroid hormone, glucocorticoid resistance, hereditary resistance to vitamin D, and estrogen resistance. Throughout, the book's distinguished contributors not only summarize the clinical features of these and related disorders, but also illuminate their molecular bases. Hormone Resistance Syndromes provides an authoritative summary and standard reference for all those clinicians and researchers actively studying these mutations today and affords a unique opportunity to understand hormone action in normal physiology.
Dr. Robert Volpé and his distinguished contributors comprehensively review the latest thinking about the theoretical, experimental, and clinical aspects of autoimmune endocrine disorders. These world-renowned experts examine the pathogenesis and immunogenetics of these diseases, discuss the role of sex hormones in autoimmunity, and elucidate the nature of autoantigens. They also provide clinical detail on a wide variety of autoimmune endocrinopathies, including autoimmune thyroid disease, Graves' ophthalmopathy and dermopathy, human insulin-dependent diabetes mellitus, and autoimmune adrenocortical failure. Postpartum autoimmune endocrine syndromes, autoimmune hypophysitis, and the polyglandular autoimmune syndromes are also discussed in detail. Comprehensive and authoritative, Autoimmune Endocrinopathies provides today's most up-to-date understanding of the etiology and pathogenesis of autoimmune endocrine diseases.
Neurosteroids: A New Regulatory Function in the Nervous System
Etienne-Emile Baulieu, the discoverer of neurosteroids, and a panel of distinguished scientists and clinical researchers exhaustively and critically review all facets of neurosteroids involved in behavior, stress, memory, depression, anxiety, aging of the brain, and neurodegenerative diseases. These contributors illuminate the role of neurosteroids in brain development and plasticity and detail their neuromodulatory influence on GABAA, ionotropic glutamate receptors, acetylcholine receptors, sigma receptors, and calcium channels. Clearly pointing the way toward novel pharmaceutical agents that may be of significant therapeutic value, particularly with regard to aging mental functions, Neurosteroids: A New Regulatory Function in the Nervous System offers neurobiologists, psychiatrists, neurosurgeons, pharmacologists, and geriatricians the first comprehensive, state-of-the-art review of these important bioactive molecules.
The IGF System: Molecular Biology, Physiology, and Clinical Applications
It has been over 40 years since the original report by Salmon and Daughaday demon strating that the ability of GH to stimulate sulfation of cartilage was mediated by a "sulfation factor. " In the ensuing decades, it has become apparent that this "sulfation factor activity" encompasses a complex system ofligands (IGFs), receptors, and carrier proteins that are, in tum, responsible for a wide array of cellular actions. The IGF system has been demonstrated to be critically involved in both intrauterine and postnatal growth, and to have important implications in cancer biology as well, owing to the ability of the IGFs to function in endocrine, paracrine, and autocrine modes and given the wide distri bution of IGFs in virtually every organ system. The contributions to The /GF System reflect the wide span of interest in the IGF system and its implications for normal and abnormal growth and metabolism. The chapters have been divided into four broad sections: I. Molecular biology of the IGF system; II. Bio logical actions of the IGFs; III. IGF physiology; and IV. Clinical aspects of the IGFs. We have made every effort to highlight the major contemporary themes in IGF biology, but as is inevitable in such a fast-moving field, perspectives will continue to change as new information is accumulated.
Menopause: Endocrinology and Management
Leading researchers and experienced clinicians join forces not only to illuminate today's understanding of the endocrinology of menopause, but also to provide a sound basis for its successful management. These seasoned experts review in detail the cardiovascular, bone, brain, and genitourinary changes that accompany menopause and spell out the risks, benefits, and alternatives of conventional hormone replacement therapy. Selective estrogen receptor modulators (SERMs), androgen replacement, calcium supplementation, and the role of phytoestrogens are also fully reviewed. Menopause: Endocrinology and Management offers practicing physicians a comprehensive understanding of the menopause process, as well as an evidence-based approach to optimizing treatment strategies for the challenging medical problems accompanying this important period in women's lives.
Human Growth Hormone: Research and Clinical Practice
In a state-of-the-art synthesis of basic science and clinical practice, Roy Smith and a distinguished panel of researchers and clinicians review GH regulation and its action at the molecular level, and describe the basis for GH deficiency and the use of GH as therapy in a variety of clinical situations. The clinical presentation moves beyond the treatment of GH-deficient children to include the genetics of GH-deficiency, GH-deficiency in adults, osteoporosis, Syndrome X, sleep quality, GH in AIDS patients, GHRH in clinical studies. Timely and innovative, Human Growth Hormone: Research and Clinical Practice will benefit both basic and clinical researchers, as well as those clinical endocrinologists who want to use growth hormone not only in treating children, but also in treating adult disorders, including those associated with metabolic disease.
Endocrinology of Aging
Distinguished physicians critically review the clinical consequences of the endocrinological changes that occur with aging-in both men and women-and examine the use of hormonal therapy to reduce them. Topics range from bone disease and water balance in all older people, to androgen deficiency in aging males, gynecomastia, and menopause. The authors also discuss Type II diabetes in persons over 65, emphasizing the cognitive benefits of good glycemia control, and the interaction of nutrition and metabolism, focusing on hypocholesterolemia, obesity, the anorexia of aging, trace elements, and vitamins. The aging of the sympathetic nervous system and its impact on hypertension in the elderly is also covered. Timely and authoritative, Endocrinology of Aging offers endocrinologists, geriatricians, and primary care physicians critical insight into the endocrine problems of our rapidly growing elderly population.
Hormones and the Heart in Health and Disease
The maintenance of arterial blood pressure and the distribution of blood flow to the various organs of the body depends on the control of the pumping action of the heart and of the resistance of the vascular beds in the individual organs in accordance with their metabolic needs. These controls are achieved through the integrated actions of circulat ing hormones, humoral factors that are synthesized and released in the heart and blood vessels, and the autonomic nervous system. The heart, however, is not only the target for the direct and indirect actions of a number of hormones and humoral factors, it is also an endocrine organ in the traditional sense, synthesizing and secreting into the circulation chemical factors that act at distant sites. In this treatise, Hormones and the Heart in Health and Disease, we interpret "endocrinology" broadly and consider traditional hormones as well as autocoids that are secreted by the heart or that act on it. In this overview, the relevant chapters are indicated in parentheses. The discovery of atrial natriuretic peptide (ANP; atrial natriuretic factor, ANF) in the 1980s indicated that the heart does indeed function as an endocrine organ in the classic sense. ANP (Chapter I) is synthesized in the heart and secreted into the circulation for actions on the kidney, where it is a potent natriuretic agent, and on the vasculature, where it causes vasodilation. ANP can also affect myocardial contractility.
Gene Engineering in Endocrinology
During the past five to ten years, a variety of tools has been developed in the disciplines of both gene engineering, and molecular and structural biology. Some of these advances have permitted scientists not only to identify and characterize genes, but also to target these genes by disruption, thus eliminating their function in living animals, and to det- mine the biological responses to altered gene products. This has particular significance in endocrine systems, in which feedback mechanisms between the hypothalamus, pi- itary, and end organs are critical in normal physiology. Interpretation of the physiological significance, or the site of action of specific molecules in this context, has been difficult prior to transgenic technology. Major advances have occurred specifically in the areas of growth and development, and of reproduction. Coupled with analysis of naturally occurring mutations in humans, the use of transgenic animals and in vitro systems has recently allowed endocrinologists to understand the importance of specific thyroid hormone receptor isoforms in vivo, the molecular basis for generalized resistance to thyroid hormones via mutations in the nuclear receptor, and mechanisms for suppressing gene transcription. Previously designated “orphan rec- tors,” such as steroidogenic factor-1, were demonstrated to have critical roles in dev- opment and reproduction. Other nuclear receptors—including those for thyroid hormone, estrogens, androgens, and progesterone—were shown to bind to coactivator and co- pressor proteins that modified their transcriptional activity, and contributed to the ce- specific effects of the hormones.
Since the observation in the 19th century that an extract of the suprarenal bodies injected into the circulation caused a rise in blood pressure, the endocrine system has become a major component in our understanding of human physiology. The introduction of radioimmunoassay techniques and the ability to measure minimal amounts of hor mones (a term derived from the Greek "to excite") have shown that acute exercise causes a release of a large number of hormones and that chronic exercise may further lead to long-term alterations in endocrine homeostasis. Actually, almost every organ and system in the body is affected by physical activity and exercise, much of it through the endocrine and neuroendocrine system. Investigation ofthe effect of acute or chronic physical activity on the endocrine system is a complex matter since the stimulus called "exercise" has many components, such as mode, intensity, duration, and others. In addition, several other factors, such as age, gender, training status, body temperature, circadian rhythm, metabolic state, menstrual cycle, and various external conditions as well as psychological factors, can modify the effect of physical activity on hormonal secretion. Moreover, the physiol9gical stimulus of exercise often provokes several and parallel cascades of biochemical and endocrine changes. It is therefore often extremely difficult to distinguish between primary and secondary events and between cause and effect. These limitations will be discussed in Chapter 1.
Those who are familiar with the two volumes of The Year in Endocrinology may, at first glance, fail to recognize their relationship to the present volume, Contemporary Endocrinology. The name is different and the cover design different, but nonetheless the admonition against judging a book by its cover is very well taken in this instance. In fact, Contemporary Endocrinology is not only the direct linear descendant of The Year in Endocrinology, it is a purposeful clone thereof-the topics are unchanged, the talented group of authors is unchanged, and most importantly, both the objective of the work and the manner in which that objective is approached are unchanged. The objective is, of course, to assist the reader in maintaining currency with respect to important developments, both basic and clinical, in the major areas of endocrinology. We are all much too familiar, unfortunately, with the difficulty of maintaining currency these days. Our approach to dealing with the informational inflation that we are suffering is similar to that used by economists in dealing with monetary inflation, that is, to increase interest. This we have attempted to do by providing for the reader an easy-to-read group of essays in which advances in individual areas of endocrinology are re viewed broadly, synthesized, and placed into perspective by a group of authors who are authorities in their individual fields. They serve, not as guest artists, but as members of a stable Editorial Board that provides continuity by contributing to successive volumes.
Endocrine Emergencies: Recognition and Treatment
Endocrine Emergencies: Recognition and Treatment offers a state-of-the-art update on the management of endocrine, diabetic, and metabolic emergencies. Developed by renowned experts, this comprehensive and easy to read title brings the field fully up to date, setting a high standard for diagnosis and treatment in each category. All chapters begin with a summary that presents, in concentrated form, what the physician needs to know to begin the evaluation and emergency treatment of the known endocrine emergencies. This is followed by an extended discussion of the pathophysiology that can be read after initial treatment has begun. Covering such areas as hypoglycemia, acute adrenal insufficiency, ovarian hyperstimulation syndrome, thyroid storm, and pituitary apoplexy, just to name several, Endocrine Emergencies: Recognition and Treatment is an invaluable, practical resource that will be of great interest to endocrinologists, internal medicine and emergency room physicians, fellows and residents.
Endocrinology of the Vasculature
Key workers in vascular medicine and biology apply state-of-the-art techniques in cell and molecular biology to study the endothelial and vascular smooth muscle cells. The distinguished scientists and clinicians open a new area of endocrinology, which sees the vasculature and kidney as endocrine organs and sheds new light on the hormonal regulation of the cardiovascular system. They also add significantly to our current understanding of the autocrine, paracrine, and endocrine regulation of vascular function in health and in those vascular disease states that accompany diabetes mellitus, dyslipidemia, and hypertension. Endocrinology of the Vasculature is the first book to comprehensively and systematically explore the vasculature as an endocrine organ.
Diseases of the Thyroid
Nationally and internationally recognized clinicians and researchers combine the latest understanding of thyroid physiology and pathophysiology with the most up-to-date clinical knowledge to help clinical endocrinologists and primary care physicians understand and treat a wide variety of thyroid disorders from birth to old age. Topics range from neonatal thyroid screening, thyroid dysfunction during infancy and childhood, peripartum thyroid disorders, and thyroid disease in the elderly to the pathogenesis and treatment of nodular goiter, thyroid cancer, thyrotoxicosis, and hypothyroidism. The book takes advantage of the latest clinical thinking and of the newest findings of the molecular biology of thyroid hormone action.
Contemporary Endocrinology: Volume 2
Diseases of the Pituitary: Diagnosis and Treatment
Nineteen cutting-edge review articles by leading authorities provide a comprehensive overview of the normal function of the pituitary and of the diagnosis and treatment of pituitary disorders. Topics range from normal hypothalamic-pituitary interactions and the processes that disrupt them to new advances in pituitary imaging and appropriate surgical intervention in various pituitary disorders. Among the diseases discussed are congenital hypopituitarism, deficiency states, strategies for evaluating patients with hyperprolactinemia, Cushing's syndrome, acromegaly, and glycoprotein pituitary tumors.
Endocrinology of Critical Disease
Expert clinicians comprehensively review the endocrine and metabolic responses to critical illness, explore the mechanisms and outcomes (positive and negative) of those responses to severe stress, and consider possible endocrine interactions that are not yet fully defined. The contributors explain in detail the endocrine response to a multitude of critical illnesses, including cancer, liver failure, renal failure, trauma, burns, AIDS and other infections, starvation, cardiac disease, pulmonary disease, and organ transplants. The book offers significant basic knowledge of high clinical relevance by collating and defining the numerous interactions of the endocrine system and critical disease states, by discussing the basic pathophysiological processes involved, and by reviewing the clinical relevance of such responses.
Natriuretic Peptides in Health and Disease
A comprehensive, state-of-the-art review of the biochemistry, molecular and cellular biology, pharmacology, physiology, and pathology of natriuretic peptides. Written by the foremost researchers in the field, the reviews range from describing the actions of these peptides on the kidney, adrenal gland, vasculature, and brain, to their effects on immune regulation, reproduction, and cell growth. Special attention is given to the potential involvement of these hormones in clinical pathology and to their possible therapeutic use. Especially enlightening is the first-time review of molecular understanding of key cellular signaling pathways and of the importance of the vascular smooth muscle-endothelial interface.
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